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B-2016-2762
C CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2.762 19960 STEVENS CREEK BLVD CUPERTINO, CA 95014-2306 (369 05 008) SWINERTON BUILDERS SAN FRANCISCO, CA 94107 OWNER'S NAME: ERIC HOFFMAN FULY LTD PTSP DATE ISSI ED: 10/12/2016 OWNER'S PHONE: 503-350-4510 PHONE NO: 415)421-2980 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #22 Contractor SWINERTON BUILDERS. Date 08/31/2017 X BLDG —ELECT —PLUMB l: I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing ' — MECH — RESIDENTIAL X COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: 1 ST FLOOR; T.L - OFFICE (3322 S.F.) - FIRST FEDERAL CREDIT I hereby affirm under penalty of perjury one of the following two declarationsi UNION 1. I have and will maintain a certificate of consent to self -insure for Worker's REV # 1 (11/2/16) - REMOVE DRINKING FOUNTAIN FROM SCOPE Compensation, as provided for by Section 3700 of the Labor Code, for the OF WORK ISSUED 11/7/2016 1'n performance of the work for which this permit is issued. P I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $$00000.00 APPLICANT CERTIFICATION certify that 1 have read this application and state that the above APN Number: Occupancy Type; information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 369 05 008 A (Tenant Improvements),B (Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes, (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 11/7/2016 Issued by: Kim Dunbar OWNER-BUYLDERDECL ION Date: l OZ12/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RF -WOES: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the stricture is not intended or offered for inspection. sale (See.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 10120 6 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the a. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall 1. be deemed revoked. _Owner wner or authorized agent:: APPLICANT CERTIFICATION Date: 11%7/2016 1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 11/7/2016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 950144255, CUPERTINO (408) 777-3228 • FAX (408) 777-3333 buildingq&-cugertino.org ❑ NEW CONSTRUCTION ❑ ADDITION I -I AT.TRRATT0V / TT rX RPVTCT0NT / TIFFPDT D r%Dir_m.TAT DuDnmT u Q- t r_ BIdgApp_2011.doc revised 06121111 ,), r4 F-IE10s CON s PROJECT ADDRESS 1jq6Q r S /t s c eo� P y APN OWNERNAME y cue _ ��, ✓sc�-�e E MAII, Jobs &:©fl 010 1,2 E1,PsT TF STREET ADDRESS �Ir' CITY, STATE, ZIP j�_ O��% (� Iii �!%t FAX CONTACT NAME PHONE f, E-MAIL o K>M M (.9, 2 STREET ADDRESS 110 '2_ cl V E �T� /,a CrTY, STATE, ZIP FAX se-Wg 9��a ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER - 2- LICENSE TYPE ^ BUS. LIC # COMPANY NAME e f ®y 6' _IJ Un E-MAIL r FAX STREET ADDRESS c-- �® io�rnS S'f� CITY, STATE, ZIP r G!f PHONE c c®� C���� X67 ARCHITECT/ENGINEER NAME /� / 1 I tc$ e.,l C SM LICENSE NUMBER BUS. LIC # -a ©C�F� COMPANY NAME �r dl -E � EMAIL z, Sm i -kh 2FAX STREET ADDRESS ica 1 Z' eve Tom, i�� CITY, STATE, ZIP PHONE S'�-4I / fl- `'l %2- s' -DESCRIPTION OF -WORK U o'ri i s'cc� o `✓o Y,�. EXISTING USEPROPOSED USE CONSTR. TYPE D # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) sah y ,/- V L� EXISTG AREA .. r� - ` NEW FLOOR AREA F+1 DEMO AREA TOTAL NET AREA 3, 32 BATHROOM KITCHEN OTHER REMODELAREAj REMODELAREA 0 ! REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA LJDETACH - - []ATTACH # DWELLING UNITS:. IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES p BEING ADDED? ❑ NO ADDITION? ❑ NO PRE APPLICATION r1 YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES 'FN iffly TOTAL VALUATION: PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO :, `° `` F By my signature below, I certify to each of the following: I am the property owner or authorized agen to roperty owner's behalivI have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons c ' n., I authorize revresentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Ci Date: ['/!➢ ! / / SUPPLEMENTAL INFORMATION REQJ. New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure _ form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BIdgApp_2011.doc revised 06121111 ,), r4 F-IE10s CON s CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19960 STEVENS CREEK BLVD CUPERTINO, CA 95014-2306 (369 05 008) CONTRACTOR: SWINERTON PERMIT NO: B-2016-2762 BUILDERS SAN FRANCISCO, CA 94107 OWNER'S NAME: ERIC HOFFMAN FMLY LTD PTSP DATE ISSUED: 10/12/2016 OWNER'S PHONE: 503-350-4510 PHONE NO: (415) 421-2980 LICENSED ONT A TOR' DECLARATION BUILDING PERMIT INFO: License Class A. D Lic. #92 Contractor MINERTON BUILDERS Date 08/31/2017 X BLDG _ELECT _ PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH _ RESIDENTIAL X COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: 1 ST FLOOR; T.I. - OFFICE (3322 S.F.) - FIRST FEDERAL CREDIT I hereby affirm under penalty of perjury one of the following two declarations: UNION i. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. z: I have and, will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $500000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 369 05 008 B (Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting this permit. Additionally, the applicant understands and willl comply with all non -point all WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 10/12/2016 Issued by: Kim Dunbar Date: 10/12/2016 DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is s. 1, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. i, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 10/12/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. ✓ caner or authorized agent: ,'4' % `'� — APPLICANT CERTIFICATION Date: 10/12/2016 certify that 1 have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Signature Date 10/12/2016 Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 13330 TORR -E AVENUE _ CUP RTINO, CA 014-3255 % tJ (408) 777--3228 FAX (408) 777-:3333 � ttiltilnq�cut���tktt�s �r�t 0 ADi)1110 ALTERATION,dtl .REVISi ffDEFERREi3 : OR16iNAL LI_ '7 OWNER a MME INIAL. 0-6 RSTTZ STPLE T ADDRESS i � ``SI s CIVY, STATE. zit CONTACT NAM ' PHONE STREFI-ADDRESS Ckd'r',STA7E. ztF FAX OWNER € i rats r I x-nt 13 c ONTR s IOR 0 CON ItACTOR AGENT , sRcttreECT ® ENGE ;r ER, 0 DEVELOPER CI TENANT CCtY T#i ii i3R NAA;i is'LICENSE h 11it3I t LICENSETBUS, LTC 44 .2411 OOIVIPANY NA�4E E-MA1i, FAX STREET S')DRFSS - To W W's,.. Cis SISTA"M ZfP A lq�gg PHONE LIZ RRCHITECUJIAt A i k.ti E n ISL rit3F:! H BUS, LIC . en+L XWPANYNAME #'r W- A ( is`i FAX STR�L°AL�Tif ss g €�IT� sttt� tfsE Ifs �•��� tC .' .."� � ._�'��--it�U tiESC" t=i�gs�OY"��bf t,° )CIUP65 r 17 tTI C USE PROPOSED !Y USE Gtl STii.7SPE h RT IES • . � ^. :.- USE TY?F CIC : VALUATION ES) EXIST 111- ri.00R - DEMO " 7Ei7riL AREA } ` AREA 0 ETAREA ��� rATHROQM KITCHEN CiIiFtL kE:A�C3L7ELARE.� - IiF..?10DELAREA R3�.SEODELAREA ,K)RCH A2%E,@ DECK AR.£rA 'Tf7r.ALI)ECK?Ft33,'tCzlAaFA— GARAGE..APFA. DETACH O ATfiACH i}L.'Ei€ ti v i i irS; ISA SECOND) I tiiT OYES 'S aT TjRY (S t5 t'Rt-APPI.ICAiEO D1LS ffYE5,7itJETi)FC�JPYLIF ISFtIRULDGAN' Oy'rs k=t.Ann.INGAPPLO C]NO t=€.ANNINCAPPI€€€t4kL€E77ER 1, EfCH1Aret€cME? ONO Y 'cC v .t3 TttI _ By my signature below, I certifg, taeach 6f the following- tam the property € j,;,,n c�c �utf�c�rir�c{ a�e€i2 tv aet €rn �h� prod rtg acs z� is c i� �If, C i��� a�a tt�Ss application and it€e inibrma-m I hac�e prc vided is correct I IE �e rc th L7�eript"s�sn of 41�ark a€xd es ri%. iE is act urate. I agrze €a carlagl� �c ith all apptic Ibie [acai ordinances andstate fates relating to 6a4dding _Constf of Cuperiin� io ear erti ' € �identi e t IsmAa y lcaF nspt c€ian pu o es rcxaisst�iingg fApglsc rii A«eTi€, i tuts. SUPPLFWE TAL INFOR_ 4 TIt ' T It£ T I .; F�} tIr'�•Isili?fana€li dwellings: r�ppI�= icer d��nc�ltic�n p��•s��It i�aa- a � ��tF � '� �� �.�-� ilding(,}: l.3eTCItl�itiCttl iserl:Iic � r�quiced ri€Ir i�l issuatof butIdingne building.arEitl t�xldg$: ProvIdc a Csil€tI}?eti;tl I•Ii3za_�£IoiiS ;.'IiiteriilS i�i:�cinsurc' Hazardous klateria's are, being Used as part of this project, Copy of PlanningAppro al Letter or k1eetinR with Islanlaing prior Act r submittal of Building Permit applicatiat€, ldg4pp_,2011I toc°revscid?'15.421111 STATE OF CAUFORNIA INDOOR LIGHTING r.Er.NRC1.LT1-01_E (Revisers 05/151 71 �:"'l 1'!N COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 1 of 2) Project Name: "P�J(OtL_4 , n�,-gZftAgoy I - Project Address: -- IL BWA 199 W Cj"e c"' d--e—)-,l __ CA Ap code: GENERAL INFORMATION DATE OF BUILDING PERMIT PERMIT # the specifications for the energy efficiency measures for the scope of responsibility for this BUILDING TYPE )!6onresidential ❑ High -Rise Res (Common Area) ❑ HoteVMoteI (Common Area) PHASE OF New Construction 0 Addition )*Iteration El Unconditioned CONSTRUCTION SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date, the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. Date Approved By the Enforcement Agency 0 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance may /U.LZ) STATE OF CALIFORNIA INDOOR LIGHTING TLnl-r (P—i—i nll,) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 2 of 2) Project Name: TepA. Cv,ecA,�- Date Signed: Address; 2AA C' t Project Address:' 6 1-e, e— —;, 14 1- d city; Zip Coft DOCUMENTATION AUTHOR'S DECLARATION STATEMENT -le 1. 1 certify that this Certificate of Installation documentation Is accurate and complete. Documentation Author Name: C1 -e Documentation Auithc Slgf% Documentation Author panyNarne; Date Signed: Address; 2AA C' t CEA certirication Idend V — 6099Z city/state/Zip: C-1 c 14or - Pei -on Lf" RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty bfperjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code In the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices forthe scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a completed signed copy ofthis Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/installer Name; 4 PkLJ �'A UY' Responsible Buildef/inst*Ar signature; k CompanN-ame- (In cling Subcontractor or General Contractor or Builder/Owner) Positloft& Company (fftle): Z&2sV* Address: - CSLR License, ikt,5A City/State/Zip: PhonDate ®0 Signed-. CAynVh,.A cA S �-50—c> CA Building Energy Efficiency Standards -2013 Nonresidential Compliance ]Vldy 4VL;;0 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM° CEC-NRCI-LTI-02-E (Revised 12115) CALIFORNIA ENERrsv r-OMMIemnnl - CERTIFICATE OF INSTALLATION v NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 1 of 6) Project Name: C'i• M _ 1 /^ ._ _ Q` Lt, 0-ecAr ! �vto�c Project Address: /19 5l�t"�� � 1� j , , Fnf rce ent Agenc : JPnt City: /" _ r C', .rNurnaer.:Jj �'�g_(6_" Zia code: e9-0, L/ GENERAL INFORMATION DATE OF BUILDING PERMIT PERMIT # BUILDING TYPE onresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION ❑ New Construction Addition Alteration Un ❑conditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: - the specifications for the energy efficiency measures for the scope of responsibility far this Installation Certificate. Requirements in the Standards: §130.4(b) Before an Energy Management Control System (EMCS), or Lighting Control System can be recognized for compliance with the lighting control requirements in Part 6 of Title 24, the person who is eligible under Division 3 of the Business and Professions Code to accept responsibility for the construction or installation of features, materials, components, or manufactured devices shall sign and submit this Installation Certificate. If any of the requirements in this Installation Certificate fail the Energy Management Control System or Lighting Control System installation requirements, these options for controlling lighting shall not be recognized for compliance with the Building Energy Efficiency Standards. Check all that apply: PART 1 What type of Lighting Control System has been installed? ❑ A. Energy Management Control System (EMCS) - Is a computerized control system designed to regulate the energy consumption of a building by controlling the operation of energy consuming systems, such as the heating, ventilation and air conditioning (HVAC), lighting, and water heating systems, and is capable of monitoring environmental and system loads, and adjusting HVAC operations in order to optimize energy usage and respond to demand response signals. ❑ The Energy Management Control System has been installed to function as a lighting control required by Part 6 and functionally meets all applicable requirements for each application for which it is installed, in accordance with Sections 110.9, 130.0 through 130.5, 140.6 through 150.0, and 150.2; and complies with Reference Nonresidential Appendix NA7.7.2. ❑ The EMCS has been separately tested for each respective lighting control system for which it is installed to function as. B. Lighting Control System - Requires two or more components to be installed in the building to provide all of the functionality required to make up a fully functional and compliant lighting control. The installed Lighting Control System complies with the requirements checked below; and all components of the system considered together as installed meet all applicable requirements for the application for which they are installed as required in Sections 130.0 through 130.5, Sections 140.6 through 140.8, Section 141.0, and Section 150.0(k). CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 2 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL.SYSTIEM CEC-NRCI-LTI-02-E (Revised 12115) CERTIFICATE OF INSTALLATION _mi ♦,VIVIIw1Q01U1V NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 2 of 6) Project Name: VS^� �, _t CC/ _e J (� , Fnfo cem nt Agencyp,.� �S F* M } V �+ V j® �_ „ems �Jl�j Permit Number. � g .,L CitY: _ p Project Address:n9 j ,,,, Ob cc, C � 2021 Y PART 2 Lighting Control Functional requirements: Check all that apply when verifying the installation of an FMCS or Lighting Control System. L02— A. All lighting controls and equipment have been installed in accordance with the manufacturer's instructions. B. The manufacturer has provided instructions for calibration. " C. If indicator lights are integral to any components, such indicator lights consumes no more than 1 watt of power per indicator light. - "D: Cornpone-n-tsrafare regulated -by ttfieTitle 2iFWp—p-t`iance-EfficrenEy-Wqufa-tions have--6een ceTtifie�fo the -- ---- Energy Commission. ❑ E. The EMCS or Lighting Control System functions as one or more of the Time -Switch Lighting Controls checked below, and complies with all of the following requirements: 1. Automatic Time -Switch Controls meeting all requirements for Automatic Time Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: Residential automatic time -switch controls have program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is interrupted. b. Commercial automatic time -switch controls meet the following requirements. I. Has program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is interrupted; ii. Is capable of providing manual override to each connected load and shall resume normally scheduled operation after manual override is initiated within 2 hours for each connected load; and iii. Incorporates an automatic holiday shutoff feature that turns off all connected loads for at least 24 hours and then resumes normally scheduled operation. ❑ 2. Astronomical Time -Switch Controls meeting all requirements for Astronomical Time -Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Meets the requirements of an automatic time -switch control; b. Has sunrise and sunset prediction accuracy within plus -or -minus 15 minutes and timekeeping accuracy within 5 minutes per year; c. Is capable of displaying date, current time, sunrise time, sunset time, and switching times for each step during programming; d. Has an automatic daylight savings time adjustment; and e. Has the ability to independently offset the on and off for each channel by at least 99 minutes before and after sunrise or sunset. ❑ 3. Multi -Level Astronomical Time -Switch Controls, in addition to meeting all of the requirements for Astronomical Time -Switch Controls, includes at least 2 separately programmable steps per zone. I'& F. The EMCS or Lighting Control System functions as one or more of the Daylighting Controls listed below: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E (Revised 121151 .. x ` CERTIFICATE OF INSTALLATION . vann �w�rty twwuvno�ivi� NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 3 of 6) Project Name: ^I ✓5� a �._ l CV 'ri 9 �9i k't" Fnforyern�endggency:� p (... 3-- 6 t � rmitNu�m6cr; r-' Project Address: yr{ryy, /` e e—t c -ie -e 6 c p (/� cny: C � p� ( C..d A3 Code®r 1. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20 Appliance Efficiency Regulations, including the following: a. Is capable of reducing the power consumption in response to measured daylight either directly or by sending and receiving signals; b. If the system includes a dimmer, complies with the Dimmer Control device requirements in the Title 20 Appliance Efficiency Regulations. c. Automatically return to its most recent time delay settings within 60 minutes _when _put in calibration mode; d. Has a set point control that easily distinguishes settings to within 10 percent of full scale adjustment; e. Hasa light sensor that has a linear response within 5 percent accuracy over the range of illuminance measured by the light sensor; f. Has a light sensor that is physically separated from where the calibration adjustments are made, or is capable of being calibrated in a manner that the person initiating the calibration is remote from the sensor during calibration to avoid influencing calibration accuracy; and g. Complies with the Title 20 requirements for photo controls if the system contains a photo control component. 2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency Regulations, including the following that it does not have a mechanical device that permits disabling of the control. G. The EMCS or Lighting Control System functions as a Dimmer and meets all requirements for a Dimmer Control device in the Title 20 Appliance Efficiency Regulations, including the following: 1. Is capable of reducing power consumption by a minimum of 65 percent when the dimmer is at its lowest level; 2. Includes an off position which produces a zero lumen output; and 3. Does not consume more than 1 watt per lighting dimmer switch leg when in the off position. 4. Dimmer controls that can directly control lamps provide electrical outputs to lamps for reduced flicker operation through the dimming range so that the light output has an amplitude modulation of less than 30 percent for frequencies less than 200 Hz without causing premature lamp failure. 5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the dimmer if the lights are off. sal H. The EMCS or Lighting Control System meets the following requirements: 1. Is capable of automatically turning off controlled lights in the area no more than 30 minutes after the area has been vacated; 2. Allows all lights to be manually turned off regardless of the status of occupancy; and 3. Has a visible status signal that indicates that the device is operating properly, or that it has failed or malfunctioned. The visible status signal may have an override switch that turns off the signal. 4. All occupant sensing devices that utilize ultrasonic radiation for detection of occupants meet the Ultrasound Maximum Decibel Values in the Title 20 Appliance Efficiency Regulations 5. All occupant sensing devices that utilize microwave radiation for detection of occupants meet the radiation requirements in the Title 20 Appliance Efficiency Regulations 6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20 Appliance Efficiency Regulations CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 M STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM.*' CEC-NRCI-LTI-02-E (Revised 12115) CALIFORNIA ENER Y CERTIFICATE OF INSTALLATION G COMMISSION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 4 of 6) . Project Name: �g .- C Fnforceme e ® P 6" �.. ' rmit Nambcr: .�.®�^���yAF Project Address, 7 0 Irt'..V � �P ��� City: la✓�i 1 ya C'i 2io Code:'95> The EMCS or Lighting Control System functions as one or more of the Occupant Sensing Controls Checked Below: a. Occupant Sensors meeting all applicable requirements for Occupant Sensor Control devices in the Title 20 Appliance Efficiency Regulations b. Motion Sensors meeting all applicable requirements for Motion Sensor Controls devices in the Title 20 Appliance Efficien including that motion sensors are rated for outdoor use. c. Vacancy Sensors meeting all applicable requirements for Vacancy Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Does not turn on lighting automatically and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; ii. Has a grace period of no more than 30 seconds and no less than 15 seconds to turn on lighting automatically after the sensor has timed out; and Ill. Does not have an override switch that disables the sensor. ❑ d. Partial -ON Sensors meeting all applicable requirements for partial on sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: 1. Has two poles each with automatic -off functionality; F. Has one pole that is manual -on and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; and iii. Has one pole that is automatic -on and is not be capable of conversion by the user to manual -on functionality. ❑ e. Partial -OFF Sensors meet all applicable requirements for partial off sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Has two poles; iL Has one pole that is manual -on and manual off; and iii. Has one pole that is automatic -on and automatic -off and is not capable of conversion by the user to manual -on only functionality. f. Occupant Sensing Control systems consist of a combination of single or multi-level Occupant, Motion, or Vacancy Sensor Controls, and all components installed to comply with manual -on requirements are not capable of conversion by the user from manual -on to automatic -on functionality. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 1 n STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E (Revised 12115) CALIFORNIA ENERGY COMMISSION c's CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 5 of 6) Project Names ProjectAd �� i..rz^'�-ill,.- ��i t t City: WIC �� _ Zia Cade: /'IP FV Y 5 f PART 3 Requirements for which the control is being installed to complied with: Identify all requirements in the Standards for which the EMCS or Lighting Control System is installed to function as and complies with: Check all that are applicable 4A. Section 130.1(a) Area Controls. , B. Section 130.1(b) Multi -Level Lighting Controls Jff�,C. Section 130.1(c) Shut -OFF Controls i-W)Avtomatic B -- — - 0 E. Section 130.1 (e) Demand Responsive Controls. �F. Section 130.5 (d) Circuit Controls for 120 -Volt Receptacles. If installed to qualify fora Power Adjustment Factor, submit this installation Certificate in addition to the PAF Installation Certificate. ❑ G. To qualify for the PAF for a Partial -ON Occupant Sensing Control in TABLE 140.6-A ❑ H. To qualify for the PAF for an occupant sensing control controlling the general lighting in large open plan office areas above workstations, in accordance with TABLE 140.6-A ❑ I. To qualify for the PAF for a Manual Dimming System PAF or a Multiscene Programmable Dimming System PAF in TABLE 140.6-A J. To qualify for the PAF for a Demand Responsive Control in TABLE 140.6-A ❑ K. To qualify for the PAF for Combined Manual Dimming plus Partial -ON Occupant Sensing Control in TABLE 140.6-A CA Building Energy Efficiency Standards -2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM',OAD, —IA --n2-E fpa%'!.A 1211 r! CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 6 of 6) Project Name: cerraa-� Address-. o Project Mtd L.cfty: C/ af—�"-o Phone: 3w - q kv 0 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Docurnentatia o I U Documentatio i Author qompany Name: Date signed: Address-. o CEA CertificaLion Idenfilication (if applicable); ATF-coLlca City/state/zip: ccq q (boy Phone: 3w - q kv 0 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code In the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or Installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that Identifies the specific requirements for the scope of construction or installation identified an this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. _ Responsible Builder/Installer Name; Responsible Builder/In allersig tu Companame: (Inst;4*i;Subcontractor or General Contractor or Posliion —With Cornpady'(Title): Builder/owner) CSLB License, W -5A0 City/state/zip; i Phone Date Signed: —3 ge) nl'esn 9V:w!liJk , alv 045220B (4013 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 o ` FILE NO STATE OF CALIFORNIA MOOR LIGHTlNG ® [LlGH ff lNG CONTROLS _ -�`� t� Q�✓�Ali CEC-NRCC-LTI-02-E (Revised 08/15) CALIFORNIA ENERGY COMMISSION— r QLighting CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E Efficiency Regulations in accordance with Section 110.9. Indoor Lighting - Lighting Controls Lighting shall be controlled by a lighting control a system or energy management control system in accordance with §110.9. An Installation Certificate (Page 1 of 3) 0 shall be submitted in accordance with Section 130.4(b). Project Name:FirstTech Federal Credit Union Date Prepared: 9/x.5/2016 One or more Track Lighting Integral Current Limiters shall be installed which have been certified to the Energy Commission in accordance with §110.9 and The NRCC-LTI-02-E shall be used to document all mandatory and prescriptive lighting controls that are applicable to the project. A. Mandatory Ligl Ung Control Declaration Statements (Indicate if the measure applies by checking yes or no below.) YES NO Control RegWrements shall be controlled by self-contained lighting control devices which are certified to the Energy Commission according to the Title 20 Appliance QLighting Efficiency Regulations in accordance with Section 110.9. Lighting shall be controlled by a lighting control a system or energy management control system in accordance with §110.9. An Installation Certificate 0 shall be submitted in accordance with Section 130.4(b). ® O One or more Track Lighting Integral Current Limiters shall be installed which have been certified to the Energy Commission in accordance with §110.9 and §130.0. Additionally, an Installation Certificate shall be submitted in accordance with Section 130.4(b). A Track Lighting Supplementary Overcurrent Protection Panel shall be installed in accordance with Section 110.9 and Section 130.0. Additionally, an O Installation Certificate shall be installed in accordance with Section 130.4(b). 0 o All lighting controls and equipment shall comply with the applicable requirements in §110.9 and shall be installed in accordance with the manufacturer's instructions in accordance with Section 130.1. E) Q All luminaires shall be functionally controlled with manually switched ON and OFF lighting controls in accordance with Section 130.1(a). General lighting shall be separately controlled from all other lighting systems in an area. Floor and wall display, window display, case display, ornamental, Q 0 and special effects lighting shall each be separately controlled on circuits that are 20 amps or less. When track lighting is used, general, display, ornamental, and special effects lighting shall each be separately controlled; in accordance with Section 130.1(a)4. ® The general lighting of any enclosed area 100 square feet or larger, with a connected lighting load that exceeds 0.5 watts per square foot shall meet the multi-level lighting control requirements in accordance with Section 130.1(b). G 0 All installed indoor lighting shall be equipped with controls that meet the applicable Shut -OFF control requirements in Section 130.1(c). 0 (2) Lighting in all Daylit Zones shall be controlled in accordance with the requirements in Section 130.1(d) and daylit zones are shown on the plans. © Lighting power in buildings larger than 10,000 square feet shall be capable of being automatically reduced in response to a Demand Responsive Signal in accordance with Section 130.1(e). Before an occupancy permit is granted for a newly constructed building or area, or a new lighting system serving a building, area, or site is operated for normal use, indoor lighting controls serving the building, area, or site shall be certified as meeting the Acceptance Requirements for Code Compliance in accordance with Section 130.4.(a). The controls required to meet the Acceptance Requirements include automatic daylight controls, automatic shut -OFF controls, and demand responsive controls. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA INDOOR LIGHTING — LIGHTING CONTROLS CEC-NRCC-LTI-02-E (Revised 08/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E Indoor Lighting - Lighting Controls (Page 2 of 3) Project Name: First Tech Federal Credit Union Date Prepared: 9/15/2016 F Credit Calculation j A separate document must be filled out for Conditioned and Unconditioned Spaces. This page is used only f; r the following: ❑✓ CONDITIONED SPACES ❑ UNCONDITIONED SPACES I B. Mandatory and Prescriptive Indoor Lighting Control Schedule, PAF Calculation, and Field Inspection Checklist P�, F Credit Calculation t � � =ti _T N Standards Complying With s r— j r) 0 rt na m E (✓ all that apply, or leave blank if = o `� = S. (D Lighting Control Schedule Exempted) n — w Q o v T x ro om° o Q� o A B C D E F G H I i j K L M N O Type/ Description of Lighting Control (i.e.: occupancy sensor, # to, 0; Ntol Location in Building automatic time switch, of 0 0 0 0 0 0 o v dimmer, automatic daylight, Units N v o s N " N a N rn Cn etc.. ) Private Offices Occ Sensor, Dimmer 6 1560 n/a 0 ❑✓ Q Q Open Areas Dimmer, Auto Time Switch 2 550 n/a 0 ❑✓ Q Suites Occ Sensor 3 ;120 n/a 0 ❑✓ Q Q ATM Room Occ Sensor 1 • • 138 n/a 0 ❑✓ Q Q Work Room Occ Sensor 1 • 76 n/a 0 F.1� Q Q 0 ❑ 0 Q 0 ❑ Q Q Control Credit PAGE TOTAL (Sum of Column M): 0 IF MULTIPLE PAGES ARE USED, ENTER SUM TOTAL OF Control Credit for all pages HERE (Sum of all Column M): ! Enter Control Credit total into NRCC-LTI-01-E; Page 1. 1. §130.1(a) =Manual area controls; §130.0(b) = Multi Level; §130.1(c) =Auto Shut -Off; §130.1(d) =Mandatory Daylight; §130.1(e) =Demand Responsive; §140.6(d) _ Additional lighting controls installed to earn a PAF; §140.6(d) = Prescriptive Secondary Sidelit Daylight Controls. 2. Check Table 140.6-A for correct Factor. PAFs shall not be traded between conditioned and unconditioned spaces. As a condition ito earn a PAF, an Installation Certificate is also required to be filled out, signed, and submitted. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance I August 2015 STATE OF CALIFORNIA INDOOR LIGHTING - LIGHTING CONTROLS I rte.: t CEC-NRCC LTI-02-E (Revised 08/15) CALIFORNIA ENERGY COMMISSION NRCC-LTI-02-E CERTIFICATE OF COMPLIANCE Indoor Lighting - Lighting Controls {Page 3 of 3) Project Name:Date Prepared: 9 j 5f 2016 First Tech Federal Credit Union DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Eric Uribe Documentation Author signature: signature Date: 9-15-2016 Company: kW Engineering Address: CEA Certification Identification (if applicable): 28717th Street, Suite 300 City/state/zp: Oakland, CA 94612 Phone: 510 (SIO) 834-6420 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. Professions Code to accept responsibility for the building design or system design identifii I d on this Certificate of Compliance 2. 1 am eligible under Division 3 of the Business and (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. with the information provided ided on other applicable compliance 4. The building design features or system design features identified on this Certificate of Compliance are consistent documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit 5. 1 that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued fort lapplication. a building, and made available to the will ensure enforcement agency for all applicable inspections. i understand that a completed signed copy of this Certificate of Compliance is required o be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Signature:,..., Responsible Designer Name: Eric Uribe Company: kW Engineering Date signed: 9-15-2016 Address: 287 17th Street, Suite 300 License: M36969 City/State/Zip: Oakland, CA 94612 Phone: (510) 834-6420 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 \ * \ ' STATE——----'— v A separate page must be filled out for Conditioned and Unconditioned Spaces. This page is only for: CONDITIONED spaces UNCONDITIONED spaces A. SUMMARY TOTALS OF LIGHTING POWER ALLOWANCES - If using Complete Building Method for compliance, use only the total in column (a) as total allowed building watts. - If using Area Category Method, Tailored Method, or a combination of Area Category and Tailored Method for compliance, use Only the total in column (b) as the total allowed building watts 1 . Complete Building Method Allowed Watts. Documented in section B of NRCC-LTI-03-E (below on this page) 3654.2 Total from section C-3 2. Area Category Method Allowed Watts. Documented in section C-1 of NRCC-LTI-03-E (below on this page) a 0 3. Tailored Method Allowed Watts. Documented in section A of NRCC-LTI-04-E x TOTAL ALLOWED BUILDING WATTS. Enter number into correct cell on NRCC-LTI-01, Page 2, Row:1, 3654.2 10 Check here if building contains both conditioned and unconditioned areas. B. COMPLETE BUILDING METHOD LIGHTING POWER ALLOWANCE Watts Total from section C-2 0 Total from section C-3 0 Total Watts. Enter Total Watts into section A, row 2 (Above on this page) TYPE OF BUILDING (From §140.6 Table 140.6-B) WATTS PER (ft') x COMPLETE BLDG.AREA ALLOWED WATTS Financial Institution Building 3322 3654.2 3322 Total Watts. Enter Total Watts into section A, row 1 (Above on this 3654.2 C -1 AREA CATEGORY METHOD TOTAL LIGHTING POWER ALLOWANCES (D plus E) Watts Total from section C-2 0 Total from section C-3 0 Total Watts. Enter Total Watts into section A, row 2 (Above on this page) 0 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA INDOOR LIGHTING POWER ALLOWANCE CEC-NRCC-LTI-03-E (Revised 08/15) i 4n. I4 I /gni 1c7nor.11n Mr.I- nnnnftfil-nni CERTIFICATE OF COMPLIANCE N RCC-LTI-03-E Certificate of Compliance - Indoor Lighting Power Allowance (Page 2 of 4) Project Name First Tech Federal Credit Union oa`eP`ePa`ed: 915/2016 i A separate page must be filled out for Conditioned and Unconditioned Spaces. This page is only for: ❑ CONDITIONED spaces ❑ UNCONDITIONED spaces C -2 AREA CATEGORY( METHOD GENERAL UGHTING POWER ALLOWANCE - Do not include portable lighting for offices. Portable lighting for offices shall be documented only in section B of NRCC-LTI-01-E. - Separately list lighting for each primary function area as defined in §100.1 of the Standards. I j A B X C = D AREA CATEGORY (From §140.6 Table 140:6-C) WATTS PER (ft) AREA (ft) ALLOWED WATTS Location in Building Primary Function Area per Table 140.6-C N/A N/A 0 N/A I 0 N/A 0 N/A i 0 N/A 0 N/A 0 I 0 0 i j 0 0 0 i 0 0 I 0 0 TOTALS 0 Enter sum total Area Category allowed watts into section C-1 of NRCC-LTI-03-E (this compliance form) 0 WATTS CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 I STATE OF CALIFORNIA MOOR UGHTM POWER ALLOWANCE CEC-NRCC-LTI703-E (Revised 08/15) r rni iFnRnun FniFRry rnnnnniSRiM CERTIFICATE OF COMPLIANCE NRCC-LTI-03-E Certificate of Compliance - Indoor Lighting Power Allowance (Page 3 of 4) Project Name: First Tech Federal Credit Union Date Prepared: 9/ 5/2016 r i separate page must be filled out for Conditioned and Unconditioned Spaces. This page is only for: CONDITIONED spaces ❑ UNCONDITIONED spaces i C-3 AREA CATEGORY METHOD AD®11TI]ONAL LlIGbTI]NG WATTAGE ALLOWANCE (from TaWe 9.4006-C F®®tno es) A B C D E F G Primary Function Sq Ft or linear ft 1 Additional Watts Allowed Wattage Allowance (B x C) Description(s) and Quantity of Special I Luminaire Types in each Primary Function Area Total Design Watts 3 ALLOWED WATTS Smaller of D or F N/A 0 N/A 0 j N/A 0 N/A 0 N/A 0 N/A 0 N/A 0 0 0 0 0 0 0 0 0 0 0 0 TOTALS —Enter into TOTAL AREA CATEGORY METHOD ADDITIONAL ALLOWANCES 1. Use linear feet only for additional allowance for white board or chalkboard. All other additional Area Category allowances shall 2 . Additional watts are available only when allowed according to the footnotes on bottom of Table 146-C, which include: Specialized Precision commercial and industrial work; Per linear foot of white board or chalk board; Accent, display and feature lighting; an� 3. Luminaire classification and wattage shall be determined in accordance with §130.0(c) of the Standards. —Section C-1 0 use watts per square foot. task work; Ornamental lighting; Videoconferencing Studio lighting.. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA INDOOR LIGHTING POWER ALLOWANCE CALIFORNIA ENERGY COMMISSION $0 CEC-NRCC-LTI-03-E (Revised 08115) NRCC- CERTIFICATE OF COMPLIANCE (Page 4 of 4) Certificate of Compliance - Indoor Lighting Power Allowance 016 —�roiect First Tech Federal Credit Union 56-cummxnON AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and co P Eric Uribe Company: kW Engineering Signature Date: 9-152016 CEA Certification Identification (if applicable): Address: 287 17th Street, Suite 300 City/State/Zip: Oakland, CA 94612 Phone: (510) 834-6420 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. the building design or system design identifi d on this Certificate of Compliance 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for (responsible designer). ials, components, and manufactured devices for the building design or system lesign identified on this Certificate of 3. The energy features and performance specifications, mater Compliance conform to the requirements of Title 24, Part I and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information pro , . ided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permitapplication. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, I and made av . allable to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Complianc builder provides to the building owner at occupancy. Responsible Designer Signature: Responsible Designer Name: Eric Uribe I : kW Engineering Date Signed: 9-15-2016 287 17th Street, Suite 300 License: M36969 a/Zip: Oakland, CA 94612 Phone: (510) 834-6420 -2Oz3Nonresidential Compliance August 2015 11 STATE OF CALIFORNIA tr I L INDOOR LIGHTING CEC-NRCC-LTI-01-E (Revised 08115) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTI-d1-E Indoor Lighting (Page 1 of 5) ProjectName: Date Prepared: A. General Information For detailed instructions on the use of this and all Energy Efficiency Standards compliance documents, refer to the Nonresidential Manual published by the California Energy Commission. YES NO FORM TITLE j Climate Zone: Conditioned Floor Area ; ® NRCC-L7I-02-E Lighting Controls, Certificate of Compliance, and PAF Calculation. All Pages required on plans for all submittals. ® NRCC-LTI-03-E Indoor Lighting Power Allowance Q NRCC-LTI-04-E Tailored Method Worksheets Unconditioned Floor Area: NRCC-L7I-05-E Line Voltage Track Lighting Worksheets Building Type: Nonresidential ❑ High -Rise Residential ❑ otel/Motel ❑ Schools ❑ Relocatable Public Schools ❑ Conditioned Spaces ❑ Onconditioned Spaces Phase of Construction: ❑ New Construction ❑ Addition Iteration Method of Compliance: ❑ Complete Building ❑ Area Category ❑ Tailored Project Address: B. Lighting Compliance Documents (select yes for each document included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance documents, refer to the Nonresidential Manual published by the California Energy Commission. YES NO FORM TITLE 0 E�'' NRCC-L7I-01-E Certificate of Compliance. All Pages required on plans for all submittals. .� ® NRCC-L7I-02-E Lighting Controls, Certificate of Compliance, and PAF Calculation. All Pages required on plans for all submittals. ® NRCC-LTI-03-E Indoor Lighting Power Allowance Q NRCC-LTI-04-E Tailored Method Worksheets C) NRCC-L7I-05-E Line Voltage Track Lighting Worksheets CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 STATE OF CALIFORNIA INDOOR LIGHTING rni c eoi A nvjic V CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE N RCC-LTI-01-E Indoor Lighting (Page 2 of 6) Project Name: w, ` Date Prepared: Indoor Lighting Pow C. Summary of Allowed Lighting Power Conditioned and Unconditioned space Lighting must not be combined for compliance Indoor Lighting Power for Conditioned Spaces Indoor Lighting Pow r for Unconditioned Spaces Watts ® NRCI-LTI-01-E - Must be submitted for all buildings Watts field Spector Installed Lighting ® Installed Lighting 1 (EMCS), Field Inspector 1. N RCC-LTI-01-E, page 4 + NR C-LTI-01-E, page 4 + ❑ Field Inspector 2 PORTABLE ONLY FOR OFFICES + ® N RCC-LTI-01-E, page 3 f a ❑ Field Inspector 3. Minus Lighting Control Credits ® Minus Lighting Control Credits p ` i, 3 `t I'( ® NRCC-LTI-02-E, page 2 NRCI-LTI-06-E - Must be submitted for additional wattage installed in a video conferencing studio to be rec 1�( NR C-LTI-02-Epage 2 1 4' Adjusted Installed Lighting Power 0 r Adjusted Instal ed Lighting Power = fl 1314f, l (row 1 plus row 2 minus row 3) 1 (r w 1 minus row 3) 5. Complies ONLY if Installed <_ Allowed Complies ONLY if Installed <_ Allowed 6' Allowed Lighting Power Allowed Lighting Power �, i �'�`` Conditioned NRCC-LTI-03-E, page 1 3OLl12- Unconditioned NRCC-LTI-03-E, page 1 D. Declaration of Required Installation Certificates Declare by selecting yes for all Installation Certificates that will be submitted. (Retain copies and verify forms are completed and Signed.) YES NO Form/Title ® NRCI-LTI-01-E - Must be submitted for all buildings field Spector ® NRCI-LTI-02-E - Must be submitted for a lighting control system, or for an Energy Management Control System (EMCS), Field Inspector to be recognized for compliance. �, NRCI-LTI-03-E - Must be submitted for a line -voltage track lighting integral current limiter, or for a supplementary ❑ Field Inspector ® overcurrent protection panel used to energize only line -voltage track lighting, to be recognized for compliance. ® NRCI-LTI-04-E - Must be submitted for two interlocked systems serving an auditorium, a convention center f a ❑ Field Inspector conference room, a multipurpose room, or a theater to be recognized for compliance. ® NRCI-LTI-05-E -Must be submitted for a Power Adjustment Factor (PAF) to be recognized for compliance. ❑ Field Inspector ® NRCI-LTI-06-E - Must be submitted for additional wattage installed in a video conferencing studio to be rec gnized for ❑ Field Inspector compliance. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance i August 2015 STATE OF CALIFORNIA INDOOR LOGHT9NG i A; r..A 11F(1RNIA FNFRr�Y r C)MI Aliisinr i CERTIFICATE OF COMPLIANCE NRCC-LTI-01-E Indoor Lighting (Page 3 of 6) p ) Project Name: � ^�� A f ? , „-2 t`J, d V � P.� d� bate Prepared: E. Decilaration of Required Certificates of Acceptance i Declare by checking all of the Certificates of Acceptance that will be submitted. (Retain copies and verify forms are completed anal signed.) YES NO Form/Title omplete Building Method is used for compliance, list each different type of luminaire on separate lines. ® NRCA-LTI-02-A - Must be submitted for occupancy sensors and automatic time switch controls. function area on separate lines Field Inspector ❑ Also include track lighting in schedule, and submit the track lighting compliance form (NRCC-LTI-05-E) when line -voltage track! 0 NRCA-LTI-03-A - Must be submitted for automatic daylight controls. I i Field Inspector r NRCA-LTI-04-A - Must be submitted for demand responsive lighting controls. _ ❑ Field Inspector. A se rate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces. Installed Lighting Power listed on thi Lighting Schedule is only for: NDITIIGNED SPACE ❑ UNCONDITIONED SPACE I F. indoor Lighting Schedule and Field Inspection Energy Checkllist ❑ T a ual indoor lighting power listed on this page and on the next page includes all installed permanent and planned portable Ze lighting systems. omplete Building Method is used for compliance, list each different type of luminaire on separate lines. hen Area Category Method or Tailored Method is used for compliance, list each different type of luminaire by each different function area on separate lines ❑ Also include track lighting in schedule, and submit the track lighting compliance form (NRCC-LTI-05-E) when line -voltage track! lighting is installed. STATE OF CALIFORNIA MOOR L� GHTONG CEC-NRCC-LTI-01-E (Revised 081151 /"`AI ICll0Al1A CAIC[J r_v nlln nn AICCl/l Al 'k'`+Y'�� CERTIFICATE OF COMPLIANCE N RCC-LTI-01-E Indoor Lighting k J I (Page 4 of 6) Project Name: Date Prepared: G. Mstaiied Por tablIe Luminaures 6n Offices,— Exce Von to Section 140e6(a) i - This section shall be filled out ONLY for portable luminaires in offices (As defined in §100.1). All other planned portable luminal es shall be documented on next page of this compliance form. - This section is used to determine if greater than 0.3 watts of portable lighting is planned for any office - Fill out a separate line for each different office. Small offices that are typical (having the same general and portable lighting) ma be grouped together. This allowance shall not be traded between offices having different lighting systems. Office Portable Luminaire Schedule Office Installed Portable Luminaire Watts Per Square Foot i Office Location Field Inspector 1 2 3 4 5 6 7 8 9 10 Installed If GG:5 0.3, Z portable o, c Watts enter i Identify Office area in �. 3 CY luminaire ?v M per zero; G5 x G7 which these portable m m Complete luminaire Description W. watts in square _ (Le., LED, under cabinet, furniture mounted Watts per D o N -+ this office� m (° foot if GS> 0.3, luminaires are installed direct/indirect} Luminaire (G2 x G3) (G4 / G5) (G6-0.3) q. Q p l 0 0 Q o 0 0 ® 0 Q 0 O O nter sum total of all pages into NRCC-LTI- Total installed portable luminaire watts that are greater than 0.3 watts per square foot per office: 01-E; Page 2 I I STATE OF CALIFORNIA MOOR LOGHTONG CEC-NRCC-LTI.01=E (Revised 08115) CALIFORNIA ENERGY COMMISSION y` CERTIFICATE IF COMPLIANCE NRCC-LTI-d1-E Indoor Lighting (Page 5 of 6) Project Narne; e t r - CV � CAi kAIlNJ( L'� m`� Date Prepared. ocation As crate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces. Installed Lighting Power listed on this Lighting Schedule is only for: CONDITIONED SPACE ❑ lJNCONDITOONED SPACE Co MOOR UG TMG SCHEDULE and MLD MPECTMN ENERGY (CHECK QST Lumiinaire Schedu0e Installed Watts ocation Field Inspector 1 2 3 4 5 6 7 8 Haw wattage was determined o to Complete Luminaire Description CL 'F a ^. Oi an Ln bb w ¢ S E E (Le, 3 lamp fluorescent troffer, 'E E o o Primary Function area in which Z :t F32T8, one dimmable electronic ballast) J u ¢ 'M these luminaires are installed Pass Fail L-0 �>- iAol ❑ 406 '—' ep 3 rt® kL— IDVJ ❑ 3 C-'-- _ L -M? m o �o .�, '1 _ 40 i El=CvE' 5 °2-006 CxL.l v "I (p TAW ❑ ❑ o ❑ ❑ 0 INSTALLED WATTS PAGE TOTAL: (�5 Enter sum total of all pages into I NRCC-L7I-01- ; Page 2 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance August 2015 E STATE OF CALIFORNIA MOOR LOGHTONG CEC-NRCC-LTl.n1-F fRauicaA nwi-m ON rnr iFnRnun FnrGRry cnnnnntccinnl '`_'"''� CERTIFICATE.OF COMPLIANCE NRCC-LTI-01-E Indoor Lighting (Page 6 of 6) Project Name: Date Prepared: Documen La Lion AuLhor Signa Lure: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation AulhorName; ( Documen La Lion AuLhor Signa Lure: i Company: > 'C—C✓!Y Q Signature Datc: g_ ✓9J i N Address: t CEA Certification Identification (if applicable};4)0 (p q� City/State/Zip: p^ Com/ Phone: RESPONSIBLE PERSO 5 DECLARATION STATEMENT certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design 'identified on this Certificate of Compliance (responsible designer). 3. The energyfeatures and performance specifications, materials, components, and manufactured devices for the building design or system esign identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information p4ided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. I will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) i ued forth, e building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Complyy ce" equiredo be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: s q �y ter Responsi esi Vn: g i Company: Date Signed: Address ,c G License: City/State/Zip: 9 too Phone: d �O r 4 KV August 2015 CUPERTINO PURPOSE: CALGREEN NON-RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P,E,, C,B4O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinq(@cupertino.org The non-residential provisions of the 2013 CalGreen Code outline planning, design and development methods that include environmentally responsible site selection, building design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the means of conserving water used indoors, outdoors and in wastewater conveyance; outlines means of achieving material conservation and resource efficiency; and outlines means of reducing the quantity of air contaminants. Project Name:ww__.. l Credit Union First Tech Federammmmmmmmmmmmmmmmmm .._._.�m� Project address: 19960 Stevens Creek Blvd. ti i l t d i Interor remodel exswn��������� Project Descri tion: branch Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2013 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. 1FelHI. I..[) LOU'1 CO[A_ COIIO[IIL.JANCE Page 1 of 9 U evued By' °� �� °����°"� �� A ...........CalGreen Non -Res Checklist.doc revised 01123114 5.106.4 Bicycle parking. Comply with Sections 5.106.4.1 and 5.106.4.2; or local is meet ordinance, whichever stricter. 5.106.4.1.1 Short-Term bicycle parking. If the qualified project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the visitors' entrance, readily visible to passers-by, for 5 percent of visitor motorized vehicle parking spaces being added, with a minimum of one two-bike capacity rack, 5.106.4.1.2 Long-Term bicycle parking. For qualified buildings with overry L� 10 tenant-occupants, provide secure bicycle parking for 5 percent of tenant vehicle parking spaces being added, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of low-emitting, fuel-efficient and carpool/van pool vehicles as ❑ shown in Table 5.106.5.2. 5.106.8 Light pollution reduction. Outdoor lighting systems shall be ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones ❑ 1 — 4 as defined in Chapter 10 of the California Administrative Code; and 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM-15-11; and ❑ ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106,8, or ❑ ❑ Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. Wpaving. 5.106.10 Grading and The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ❑ site grading or a drainage system will manage all surface water flows. Division Performance Requirements 5.201.1 Scope. The California Energy Commission will continue to adopt tN mandatory building standards. Division• • Indoor Water Use 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503 1A and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. ❑ Separate submeters shall be installed as follows: 1, For each individual leased, rented or other tenant space within the building projected to consume more than 100 gal/day. 2. Where separate submeters are u for water supplied to the following systems: C U 11' 1:1:11 "T" a. Makeup for cooling to S' r iii iii iii iii r llpah is u�rm rt an 5 0 gpmr b. Makeup water for evaporativ greater than 6 gpm. c. Steam and hot-water boilers VI: I:tgyiIr1Il..li Page 2 of 9 V� wa. t � � �� � — CalGreen Non-Res Checklist. doe revised 01/23/14 5.303.1.2 Excess consum A..se............ - _......._ p tion. parate submeter shall be provided for any tenant within a new building or within an addition that is projected �1I LJ to consume > 1,000 gal/day. 5.303.2 Water reduction. Plumbing fixtures shall meet the maximum flow rate r� values shown in Table 5.303.2,3, Exception: Building that demonstrate 20 -percent overall water use reduction, 5.303.2.1 Areas of addition or alteration. For those occupancies within the authority of the California Building Standards Commission, as specified in Section 103, the provisions of Section 5.303.2 and Section 5.303.3 shall apply to new fixtures in additions or areas of alterations to the buildings. 5.303.4 Wastewater reduction. Each building shall reduce by 20 percent wastewater by one of the following methods: 1. The installation of water -conserving fixtures or ® ❑ 2. Utilizing non -potable water systems. ❑ ❑ 5.303.6 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code (CPC), and shall meet the applicable standards referenced in CPC Table 14011 and CalGreen Chapter 6. Outdoor Water Use 5.304.1 Water budget. A water budget shall be developed for landscape? �I irrigation use. 5.304.2 Outdoor potable water use. For new water service or for addition or alteration requiring upgraded water service for landscaped areas of at least 1,000 sq,ft, but not more than 5,000 sq.ft., separate submeters or metering devices shall be installed for outdoor potable water use. 5.304.3 Irrigation design. In new nonresidential construction or building addition or alteration with at least 1,000 but not more than 2,500 sq.ft, of cumulative landscaped area, install irrigation controllers and sensors which n include the following criteria, and meet manufacturer's recommendations. LJ 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil moisture -based controllers that El automatically adjust irrigation in response to changes in plants' needs as ❑ weather conditions change. 2. Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates El 11 with the controller(s). Soil moisture -based controllers are not required to have rain sensor input, Weather Resistance and Moisture Management 5.407.1 Weather protection. Provide a weather -resistant exterior wall and foundation envelope as required by Califo ing Code Section 1403.2 and California Energy Code Section 150, il turer'0Wfb1NVb01 instructions or local ordinance, whichever tr e tii _.............................................. _. _I'uui�iq f�arurfmf'..._. V"tEWiI . I'!.D i:DR CON C I:IIL.I i4CIE Page 3 of 9 Rev�ewed �' 4 �� " °��� ��..........� ° �� ��.......... CalGreen Non -Res Cheeklist.doe revised 01/23114 5.407.2 Moisture control. Employ moisture control measures by the following methods; 5.407.2.1 Sprinklers. Prevent irrigation spray on structures, ❑ 5.407.2.2 Entries and openings. Design exterior entries and/or openings ❑ to prevent water intrusion into buildings. 5.407.2.2.1 Exterior door protection. Primary exterior entries shall be covered to prevent water intrusion by using nonabsorbent floor and wall finishes within at least 2 ft around and perpendicular to such openings plus at least one of the following. 1. An installed awning at least 4 ft in depth. 2. The door is protected by a roof overhang at least 4 ft in depth. 3. The door is recessed at least 4 ft. 4. Other methods which provide equivalent protection 5.407.2.2.2 Flashing. Install flashings integrated with a drainage plane. 5.408.1 Construction waste management. Recycle and/or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with Section 5.408,1.1, 5.408.1.2, or 5„408.1.3; or meet a local construction and demolition waste management ordinance, whichever is more stringent. 5.408.1.1 5.408.1.1 Construction waste management plan. Submit plan per this section to enforcement authority. 5.408.1.2 Waste management company. Utilize a waste management company that can provide verifiable documentation that the percentage of ❑, construction and demolition waste material diverted from the landfill complies with CalGreen Section 5.408. 5.408.1.3 Waste stream reduction alternative. The combined weight of new construction disposal that does not exceed two pounds per square ❑ foot of huildino area may he deemed to meet the 50 percent minimum requirement as approved by the enforcing agency. 5.408.1:4 Documentation. Provide documentation of the waste ❑ management plan that meets the requirements listed in Section 5,408.1.1 through 5.408.1.3. 5.408.3 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land clearing shall be reused or recycled. 5.410.1 Recycling by occupants. Provide readily accessible areas that serve the entire building and are identified for the depositing, storage and collection of nonhazardous materials for recycling, 5.410.2 Commissioning. For new buildin s 10 000 square feet and over, building commissioning for all building sys ere , IIII process systems and renewable energy s e hall �I d ir1 design and construction processes of the I �I o tugt requirements shall include items listed in 410.2. p3EWi l..D I::CU COM- CC I:)II..WI C I C' C In - F ■l Ill 0 Page 4 of 9 Revs e wet �' �� ” � L...�. A�� ��.......... CalGreen Non -Res Checklist. doc revised 01123114 5.410.2.1 Owner's Project Requirements (OPR). Documented before the design phase of the project begins the OPR shall include items listed in ❑ Section 5.410.4. 5.410.2.2 Basis of Design (BOD). A written explanation of how the design of the building systems meets the OPR shall be completed at the design 0 0 phase of the building project and updated periodically to cover the systems listed in Section 5.410.2.2,. 5.410.2.3 Commissioning plan. A commissioning plan describing how the project will be commissioned shall be started during the design phase of ❑ Li El the building project and shall include items listed in Section 5.410.2.3. 5.410.2.4 Functional performance testing. Functional performance testing shall demonstrate the correct installation and operation of each component, system and system -to -system interface in accordance with the approved plans and specifications. 5.410.2.5 Documentation and training. A Systems manual and systems training operations are required. 5.410.2.5.1 Systems manual. The systems manual shall be delivered to the building owner or representative and facilities operator and shall ❑ include the items listed in Section 5.410.2.5.1. 5.410.2.5.2 Systems operations training. The training of the appropriate maintenance staff for each equipment type and/or system ❑ shall include items listed in Section 5.410.2.5.2. 5.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction andI ri reporting recommendations for post -construction phases of the building project shall be completed and provided to the owner or representative. 5.410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet or new systems to serve an addition or alteration subject to Section 303.1. 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall ^ inn! do n cs nnlinnhlo fn fho n+ + v nrniohn cc+omc lic+crl in Confinn 1 1 5410,3.2., ..NN,..,u�.., .., .,, N..,,., .,., .,,.,.,,..... ,,...,,.. .......,..,, aw....:w i, v 5.410.4.3 Procedures. Perform testing and adjusting procedures in accordance with industry best practices and applicable national standards rn on each system. U 5.410.4.3.1 HVAC balancing. Before a new space -conditioning system serving a building or space is operated for normal use, the system should be balanced in accordance with the procedures defined by ❑ national standards listed in Section 5.410.3.3.1. 5.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a final report of testing signed by the individual responsible for ❑ performing these services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of 0 ❑ guaranties/warranties for each syste incl inspection. 5.410.4.5.1 Inspections and reporl verifications and reports required by rcing age IIS 0 0 elii9 irin cY VIII II •: II) IF° Dli Dl'C II y II ,' COWfILJWMGE Page 5 of 9 Revue e� �' �� "' °��� �l.......... lA l� ��l.......... l CalGreen Non -Res Checklist. doc revised 01/23/14 Fireplaces 5.503.1 Install only a direct -vent sealed -combustion gas or sealed wood - burning fireplace or a sealed woodstove and refer to residential requirements ❑ in the California Energy Code, Title 24, Part 6, Subchapter 7, Section 150, 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase II �I emission limits a. u 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component ❑ openings shall be covered with tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 5.504.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants, caulks. Adhesives and sealants used on the project shall meet the requirements of the following standards. 1. Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or P""7 SCAQMD Rule 1168 VOC limits, as shown in Tables 5.504.4.1 and 1_J 5.504.4.2. 2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid ounces) shall comply with statewide VOC standards and other, ❑ requirements, including prohibitions on use of certain toxic compounds, of California Code of Regulations, Title 17, commencing with Section 94507. IT rn w w It n_:_a_ _....I _ _a:...-- A—L,;I•.. .—I .,I - - A ---4-;--- -1 -,11 J.JV T.T.J 1 MI MIND V M&IIII,J. 1-111—L-1 1-11— iw —.iw.1 comply with Table 5.504.4.3 unless more stringent local limits apply. ❑I 5.504.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product -Weighted MIR Limits for ROC in Section 94522(a)(3) and other requirements, including prohibitions on use of r,I 0 certain toxic compounds and ozone depleting substances (CCR, Title 17, 1� Section 94520 et seq). 5.504.4.3.2 Verification. Verification of compliance with this section shall be provided at the request of the enforcing agency. 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of at least one of the standards r listed in Section 5.504,4.4, �J 5.504.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute ❑ ❑ Green Label program,. CU1:4EIRTINO 5.504.4.4.2 Carpet adhesive. All ceiI'lii�l fnll ummt requirements of Table 5.504.4.1. ❑ lIEVHI WII�°�Di CU E COWDIJWMOE Page 6 of 9 Revue e� �' �� "' °��� ��..........A �� � ���.......... CalGreen Non -Res Checklist. doc revised 01123114 5.504.4.5 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for formaldehyde as specified in Table 5.504.4.5. 5.504.4.5.3 Documentation. Verification of compliance with this section ❑' shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following standards listed in Section 5.504.5,3. 5.504.4.6 Resilient flooring systems. For 80 percent of floor area receiving resilient flooring, installed resilient flooring shall meet at least one of the following standards listed in Section 5.504.4.6,. 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outside and return air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke (ETS) control. Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings; or as enforced ® ❑ by ordinances, regulations or policies of any city, county, city and county, California Community College, campus of the California State University or campus of the University of California, whichever are more stringent. 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Building Code, CCR, Title 24, Part 2, Sections 1203 and Chapter 14.1. 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the California Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 8 or the applicable local code, whichever is more stringent.' 5.506.2 Carbon dioxide (CO2) monitoring. For buildings equipped with _1. ,.-_J __.-+„_I .-+:1-a;_-. /�/lr1 ....... .... �.. -. ,., .J l;l-.+i.... .+.-..In nl..�ll I- - uci i iai d Lvi ni vi vci niiauvi i, vv2' so..Go o and vo ilnulic . oo iu vw OIL 10:! _ iy Wj j ' specified and installed in accordance with the requirements of the latest edition u of the California Energy Code, CCR, Title 24, Part 6, Section 121(c).' 5.507.4 Acoustical control. Employ building assemblies and components pp�� with STC values determined in accordance with ASTM E 90 and ASTM E 413. R1 ❑ 5.507.4.1 Exterior noise transmission. Wall and floor -ceiling assemblies making up the building envelope shall have an STC of at least 50 and n exterior windows shall have a minimum STC of 30 for any of the building LSI locations listed in Items 1 through 3 in Section 5.50T..5,1. 5.507.4.2 Interior sound. Wall and floor -ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of ❑ at least 40. CU1111EIRTINO Buildiing Department p3EW( .: l..D I::CrU COM- CC I:III..V II4CIE Page 7 of 9 Revue e� �' 4 �� ” °��� ��..........A �� � ���.......... CalGreen Non -Res Checklist. doc revised 01123/14 udoorwAir Qull 5.508.1 Ozone depletion and greenhouse gas reductions. Installations of HVAC, refrigeration and fire suppression equipment shall comply with Sections 5.508.1.1 and 5.508.1.2. 5.508.1.1 Chlorofluorocarbons (CFCs). Install HVAC and refrigeration equipment that does not contain CFCs. 5.508.1.2 Halons. Install fire suppression equipment that does not contain ❑ Halons. CUIIIIEIRTINO dei°iilldiiii g Ilgell ar°tirnent Page 8 of 9 V� ewe u' "'SII U L...I L...I CalGreen Non -Res Checklist. doc revised 01/23114 CALGREEN SIGNATURE DECLARATIONS Project Name: First Tech Federal Credit Union Project Address: 19960 Stevens Creek Blvd. Interior re . .. .... w ...._...�_w� Project Description: model to existing branch Inte SECTION 1 — DESIGN VERIFICATION Complete all lines of Section 1 — "Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted by the City of Cupertino. cw-etcheir Waken Owner's Signature Gretchen Wakem Owner's Name (Please Pri Mitchell C. Smith Design Signatur''"of t.tcen Mitchell C. Smith (Please Print) responsible for CalGreen compliance Name of License Professional responsible for CalGreen compliance (Please Print) mitch,srnith MG2.com Email HOQreSS for License Professional IespUn5iui8 wi Claivieeiii COM Nnai iCc SECTION 2 — IMPLEMENTATION VERIFICATION 09/19/2016 Date 09/19/2016 Date Date 206.962.6500 Phone Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone re, com lance ruu7 ming e ar°timent � vuewe � y :.SII U L...II L.... CalGreen Non -Res Checklist. doe revised 01/23/14 Page 9 of 9 Date:09/26/16